July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Aflibercept in the real world – are the visual outcomes worse in patients with diabetic macular edema who have had a cataract operation?
Author Affiliations & Notes
  • Irene Mary Stratton
    Gloucestershire Retinal Research Group, Gloucestershire Hospitals NHS FT, Cheltenham, Gloucestershire, United Kingdom
  • Peter Henry Scanlon
    Gloucestershire Retinal Research Group, Gloucestershire Hospitals NHS FT, Cheltenham, Gloucestershire, United Kingdom
  • James S Talks
    Royal Victoria Hospital, Newcastle, United Kingdom
  • Usha Chakravarthy
    Queen's University Belfast, Belfast, United Kingdom
  • Raj Mukherjee
    St James's University Hospital, Leeds, United Kingdom
  • Faruque Ghanchi
    Ophthalmology, Bradford Teaching Hospitals NHS FT, Bradford, United Kingdom
  • Sajjad Mahmood
    Manchester University NHS FT, Manchester, United Kingdom
  • Andrew Lotery
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom
  • Footnotes
    Commercial Relationships   Irene Stratton, Bayer (F), Bayer (R), Novartis (R), Novo Nordisk (R); Peter Scanlon, Bayer (R); James Talks, Bayer (R); Usha Chakravarthy, Bayer (R); Raj Mukherjee, Bayer (R); Faruque Ghanchi, Alimera (R), Allergan (R), Bayer (F), Bayer (R), Novartis (R), Roche (R); Sajjad Mahmood, Bayer (R), Bayer (C), Novartis (R), Novartis (C); Andrew Lotery, None
  • Footnotes
    Support  Funding from Bayer
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2637. doi:
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      Irene Mary Stratton, Peter Henry Scanlon, James S Talks, Usha Chakravarthy, Raj Mukherjee, Faruque Ghanchi, Sajjad Mahmood, Andrew Lotery; Aflibercept in the real world – are the visual outcomes worse in patients with diabetic macular edema who have had a cataract operation?. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2637.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose :
Aflibercept was licenced in UK for use as treatment for diabetic macular edema in 2015. Here we compare visual outcomes over 12 months between those who had previously had cataract surgery and those who had not.

Methods : Anonymised data of patients undergoing antiVEGF injections for diabetic macular edema were exported from a dedicated ophthalmology electronic patient record system. Those who had aflibercept injections only were included. Patients were included if lens status in each injection record in 12 months “phakic” or if each lens status was “pseudophakic”. The first eye treated in each patient was used. Wilcoxon Rank Sum test was used to compare groups. Linear regression was used to relate change in visual acuity (VA) over 12 months from the first injection lens status, age, baseline ETDRS letter score and number of injections. The 12 month letter score was that at the visit after the last injection prior to 12 months if it was within 8 weeks of the anniversary of the first injection.

Results :
From 21 UK centres 1153 patients were included, 265 pseudophakic (PP), 836 phakic (P). Those with previous cataract surgery were older at first injection (PP 72 (65 to 81) years (median (25th to 75th centile)) than those without (P 62( 55 to 70) years (p<0.0001)), had worse baseline VA (PP 60 (50 to 70) vs P 65 (55 to 73) ETDRS letters (p=0.0011)) and there was no difference in number of injections over 12 months (PP 5.9 (2.0) (mean (s.d.)) vs P 6.1(2.0) (p=0.17)). At 12 months the change in letter score did not differ (PP 6 (0 to 13) vs P 5 (0 to 11) (p=0.091)).
In regression analysis of the change in VA over 12 months, after adjusting for age, baseline letter score and number of injections, lens status was not associated with change in VA (p=0.39) but was associated with age ( 4 letters more in those under 65 compared with those 75 or older p=0.0008), baseline ETDRS letter score (those with fewer than 50 letters at baseline gaining 19 letters more than those with 80 or more p<0.0001). Each injection was associated with gain of 0.4 letters (p=0.03).

Conclusions : Conclusions
Prior cataract surgery did not affect the visual outcome in those given aflibercept injections for diabetic macula edema.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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